Here are a few of the most common side effects that I come across when people first start keto. Frequently the issues relate to dehydration or lack of micronutrients (vitamins) in the body. Make sure that you’re drinking enough water (close to a gallon a day) and eating foods with good sources of micronutrients. To read more on micronutrients, click here >

In the absence of CHO, however, the body must shift to fat as the primary energy source. In this case, the body catabolizes stored triglycerides, which exist in abundance in even the leanest individual. In effect, the KD provokes a physiological stimulus, i.e., CHO restriction, that mimics starvation. Due to the limited ability to store or produce CHO during periods of starvation, the body thus switches to ketogenesis, the production of ketone bodies as a primary fuel source (3).
Prior to the advent of exogenous insulin for the treatment of diabetes mellitus in the 1920's, the mainstay of therapy was dietary modification. Diet recommendations in that era were aimed at controlling glycemia (actually, glycosuria) and were dramatically different from current low-fat, high-carbohydrate dietary recommendations for patients with diabetes [1,2]. For example, the Dr. Elliot Joslin Diabetic Diet in 1923 consisted of "meats, poultry, game, fish, clear soups, gelatin, eggs, butter, olive oil, coffee, tea" and contained approximately 5% of energy from carbohydrates, 20% from protein, and 75% from fat [3]. A similar diet was advocated by Dr. Frederick Allen of the same era [4].
Thank you, Wenda! Yes, the nutrition info is based on 6 donuts. If you keep the ingredients the same but make more (smaller) donuts out of them, the macronutrients per donut would be lower. If you just multiply the ingredients by 4 to make 24 donuts that are the same size as mine (increase the # of servings on the recipe card to 24), then the nutrition info per donut would stay the same.
Hi Jan, Sorry they didn’t work for you. It’s hard to say what happened without being in the kitchen with you. Did you use exactly the same ingredients and amounts? Also, if they were not cooked, then they probably needed to be in the oven for longer. If they were clumpy, it’s also possible that the almond flour wasn’t fine blanched (it needs to be) or the batter wasn’t mixed well enough. Hope this helps.
Thanks for your quick reply. Yes, BP is fresh. My batter wasn’t runny either. In fact I was going to add some more liquid but decided to leave as it was. The only other thing it could have been is that I live at 5100′ elevation and it was cold and snowing the day I made them. I am going to make them again and see what happens. I am not giving up! 🙂
Hi Joellen, It doesn’t rise as much as a wheat bread but does a little. The almond flour being frozen might have made it worse, I’m not sure – I don’t store mine there since I go through it a lot. I’m glad you like the texture. If you want a taller loaf, you can multiply the recipe by 1.5 or even double it, but would need to increase the cook time and probably cover it to prevent browning the top too much before the middle is done.
Instead of adding sugar to your coffee, you can put a few drops of stevia in there to sweeten it up. Stevia is a great sweetener and won’t increase your blood sugar levels – so it’s a perfect way to sweeten your morning coffee. If you find stevia to have a bitter aftertaste, erythritol and monk fruit extract are two other keto-friendly sweeteners worth trying.
Hi John, Thank you for the feedback. Sometimes this bread takes a little more effort to rise and the batter has to be mixed well to create air bubbles. Use very fresh baking powder, too. The bluish tint can come from an interaction with the psyllium husk powder, and the brand I use (linked on the recipe card) doesn’t usually do this, but either way it’s safe to eat. I’m glad you still liked it!

CEREALS: Oatmeal is the quintessential hot cereal, and along with that tummy-warming satisfaction, you'll get a nice dose of fiber. A quarter of a cup of “old-fashioned" rolled oats (uncooked) boasts 4.1 grams of fiber and, along with an added source of protein such as nuts or an egg, will give you the staying power to get you to lunchtime. If you don't have the five minutes to make oatmeal, though, there are a number of ready-to-eat cereals that are high in fiber. To find the best ones, seek out whole-grain cereals with at least 4 grams of fiber per serving and no added sugars.
When in the hospital, glucose levels are checked several times daily and the patient is monitored for signs of symptomatic ketosis (which can be treated with a small quantity of orange juice). Lack of energy and lethargy are common, but disappear within two weeks.[17] The parents attend classes over the first three full days, which cover nutrition, managing the diet, preparing meals, avoiding sugar, and handling illness.[19] The level of parental education and commitment required is higher than with medication.[44]
Yes, I love Dr Berg. It is because of him I found you while searching for sugar-free recipes. I LOVE your recipes and my picky husband and son do as well. My husband was having joint issues and putting on some fat in his middle. Since starting Keto he has trimmed down and has much less joint pain. I feel so much better on a Keto diet. Thinking is more clear, more energy, less body aches and pains and much less fatigue. I have a long way to go. The diversity of your recipes make it so much easier to stick to the Keto lifestyle. I am a big fan and really appreciate your work. 🙂
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With just 4g of carbs, this pasta, made from hearts of palm, is a plant-based pasta substitute you may not have heard about before. Palmini is low in calories, high in fiber, gluten free, and looks more like traditional pasta than some other alternatives. It can be purchased canned or in pouches. While you can eat it straight from the package, it also cooks up well—keeping its pasta-like consistency.
These take care of my bread craving. And, being a person who didn’t want to start out by purchasing a donut pan, I used and 8×8 glass pan; greased and lined (the bottom) with parchment paper. The recipe has the consistency of pudding before it sets and easily conforms to the pan. Also, since I used a glass pan, I lowered the temperature to 325 degrees, cooking time was the same. I cut my ‘donut cake’ into 6ths and it’s delicious. I also I don’t add the topping. Thank you for this recipe.

Sharon M. Nickols-Richardson, PhD, RD, , Mary Dean Coleman, PhD, RD, Joanne J. Volpe, Kathy W. Hosig, PhD, MPH, RD, “Perceived Hunger Is Lower and Weight Loss Is Greater in Overweight Premenopausal Women Consuming a Low-Carbohydrate/High-Protein vs High-Carbohydrate/Low-Fat Diet,” The Journal of Pediatrics: Vol 105, Issue 9: 1433–1437; September 2005. http://www.sciencedirect.com/science/article/pii/S000282230501151X.


Participants were recruited from the Durham Veterans Affairs Medical Center (VAMC) outpatient clinics. Inclusion criteria were age 35–75 years; body mass index (BMI) >25 kg/m2; and fasting serum glucose >125 mg/dL or hemoglobin A1c >6.5% without medications, or treatment with oral hypoglycemic agents (OHA) and/or insulin. Exclusion criteria were evidence of renal insufficiency, liver disease, or unstable cardiovascular disease by history, physical examination, and laboratory tests. All participants provided written informed consent approved by the institutional review board. No monetary incentives were provided.
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